OBJECTIVETo explore the correlation among prevertebral hyperintensity (PVH), sagittal canal diameter on MRI and neurologic function of patients after cervical vertebral hyperextension injury without fracture and dislocation.

METHODSThe clinical data of 100 patients with cervical vertebral hyperextension injury without fracture and dislocation were retrospectively analyzed from September 2010 to December 2013. The patients were divided into PVH group and non-PVH group according to the presence of PVH on T2-weighted magnetic resonance imaging. There were 39 patients in PVH group, including 31 males and 8 females, aged from 21 to 83 years old with an average of (58.10 ± 14.78) years; and the other 69 patients in non-PVH group, including 49 males and 12 females, aged from 32 to 77 years old with an average of (55.05 ± 10.36) years. The sagittal disc level canal diameters of subaxial cervical spine were measured on mid-sagittal magnetic resonance imaging. The age, sex, cause of injury, and the segments of spinal stenosis were recorded. American Spinal Injury Association (ASIA) impairment scale and motor score were used to evaluate the neurological status.

RESULTSThe ASIA motor score of the group with PVH was 52.56 ± 31.97 while the ASIA motor score was 67.70 ± 22.83 in non-PVH group (P = 0.013). More patients with intramedullary hyperintensity signal on MRI were observed in the PVH group than in non-PVH group (P = 0.006). There was a significant positive correlation between ASIA motor score and sagittal disc level canal diameter of injury segment (P = 0.003). The neurological status was worse in patients with multi-level sagittal canal diameters below 8 mm.

CONCLUSIONThe PVH and the disc-level canal sagittal diameter of the injury segment are associated with neurological status. The patients with multi-level sagittal canal stenosis are vulnerable to severe cervical spinal cord injury.

Adult ; Aged ; Aged, 80 and over ; Cervical Vertebrae ; injuries ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Canal ; pathology ; Spinal Cord Injuries ; pathology ; physiopathology

Cold Temperature ; Dinoprost ; analogs & derivatives ; urine ; Dust ; Humans ; Interleukin-6 ; urine ; Thromboxane B2 ; analogs & derivatives ; urine ; Weather

BACKGROUND: Enterococci are important cause of nosocomial infections. Recently, vancomycin-resistant enterococci (VRE) has been increasingly reported as significant nosocomial pathogens. Therefore, accurate identification of enterococcal species is a prerequisite step for the appropriate antibiotic treatment and epidemiologic surveillance. We wanted to know the usefulness of PCR method compared with Vitek automatic identification system. METHODS: Totally 105 isolates were identified on the species level by Vitek (GPI card and software version R06.1), methyl-alpha-D-glucopyranoside test, and PCR methods. RESULTS: Among 105 enterococcal isolates, 59 were identified as E. faecium, 11 E. faecalis, 6 E. gallinarum by Vitek. But 29 isolates (28%) were unidentified. Subsequently all of these isolates were analyzed by PCR, the results of which were as follows: 17 E. faecium, 5 E. casseliflavus, 7 E. gallinarum. Two isolates identified as E. gallinarum by Vitek were reidentified as E. casseliflavus by PCR and other methods for phenotypic characterization. CONCLUSOIN: PCR method was more accurate and sensitive than Vitek for the identification of enterococci species.
Cross Infection ; Epidemiological Monitoring ; Polymerase Chain Reaction*

OBJECTIVEThe infarct-related artery (IRA) could not always be identified by electrocardiogram (ECG). In the present study, we attempted to explore the reason for failed IRA identification by ECG based on the comparison between ECG records and coronary angiographic findings.

METHODSAll 18-lead ECG records were compared with respective angiographic findings in 1024 consecutive patients with ST elevation myocardial infarction (STEMI) between October 2004 and July 2009. More than two continuous 18-lead ECG records were performed within 12 hours of the symptom onset in all patients. Patients with previous myocardial infarction, coronary artery bypass surgery, pacemaker implantation or ECG evidence of left bundle branch block and angiography was performed more than 12 hours time from symptom onset were excluded.

RESULTSOf all 1024 patients enrolled, the IRA were correctly identified in 854 cases and identified wrong in 96 cases and could not be identified in 74 cases by ECG. Of the failed identification in these 170 cases, IRA was left circumflex coronary artery in 76 (44.7%)cases, right coronary artery in 66 (38.8%) cases, left anterior descending branch in 20 (11.8%) cases, ramus medianus branch in 7 (4.1%) cases, and left main in 1(0.6%) case. Double-vessel and triple-vessel diseases were recorded in 27(15.9%) patients and 47(27.6%) patients respectively. Early repolarization syndrome occurred in 8 (4.7%) patients, and dextrocardia in 1 patient (0.6%). Angiographic study showed acute occlusion of a small branch in 6 (3.5%) patients.

CONCLUSIONCoronary collateral vessel can mislead judgments of the IRA by ECG. When the IRA can not be determined by ECG, left circumflex coronary artery is most likely to be the culprit vessel. Occasionally, early repolarization syndrome and anatomic variation of the coronary artery or heart and a small branch occlusion could be causes of misjudgments of IRA by ECG.

Adult ; Aged ; Coronary Angiography ; Diagnostic Errors ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis

OBJECTIVETo study the mechanism of Tongjiang granule on treating GERD.

METHODThe rats in the model group received steel wire ring-cardiamyopexy. A steel wire ring was fixed firmly on cardia. The rats in the control group underwent the cardia-plasty plus pylori ligation plus stomach-empty intestine Roux-en-Y anastomosis. The rats were divided into six groups after operations at random, which were fed up respectively with Tongjiang granule of different dosage and perpulsid. No treatment groups were taken as control.

RESULTThe experiment showed that Tongjiang granule could lighten or cure RE in the pathology, decrease the hydrochloric acid in gastric juice, in the meantime, increase the motilin in the animal blood. This study indicated that the effect of Tongjiang granule group from experimental research was better than that of the control group (perpulsid).

CONCLUSIONThe effects of Tongjiang granule on treating GERD can be achieved by decreasing the hydrochloric acid in gastric juice, increasing the motilin in blood and promoting the gastric impetus in the animal experiment.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; physiopathology ; Esophagus ; pathology ; Female ; Gastric Acid ; metabolism ; Gastric Emptying ; drug effects ; Hydrochloric Acid ; metabolism ; Male ; Motilin ; blood ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

AIMTo observe the role of melatonin receptor and GABAA receptor in sleeping time prolonged by melatonin in mice.

METHODSThe absence of the righting reflex was considered as the sleep onset and the duration of the loss of the righting reflex was recorded as the sleeping time. The effects of receptor agonist and antagonist on hypnotic activity of melatonin were studied in the paper.

RESULTSPrazosin hydrochloride, the blocker of melatonin 3 receptor, didn't affect the sleeping time prolonged by melatonin in mice. GABA, the endogenous agonist of GABA receptor, significantly potentiated the hypnotic activity of melatonin. When picrotoxin, the ligand of picrotoxin site on GABAA receptor, used together with melatonin, it significantly antagonized the sleeping time prolonged by melatonin, however, bicuculline, the specific antagonist of GABA binding site in GABAA receptor, didn't affect the hypnotic activity of melatonin in mice.

CONCLUSIONMelatonin does not exhibit its potentiation sleeping time in mice through melatonin 3 receptor. Hypnotic activity of melatonin may be mediated through picrotoxin site on GABAA receptor.

Animals ; Bicuculline ; pharmacology ; Male ; Melatonin ; physiology ; Mice ; Mice, Inbred Strains ; Picrotoxin ; pharmacology ; Prazosin ; pharmacology ; Receptors, GABA-A ; physiology ; Receptors, Melatonin ; physiology ; Sleep ; physiology

Aim:To investigate the effect of Hemangiopoietin (HAPO) on the hematopoiesis reconstitution in sub-lethally irradiated Balb/c mice.Methods: Balb/c mice were underwent total body irradiation at 700 cGy 137Cs ? radiation and were treated with HAPO or recombinant human granulocyte colony stimulating factor (rhG-CSF) after irradiation. The hematopoiesis reconstitution of mice were detected. Cells from bone marrow of Balb/c mice were cultured with HAPO or rhG-CSF for 24 hours or 72 hours before or after the cells were irradiated. The viability of cells were assessed and the ability of in vitro hematopoiesis reconstitution were also detected. Result: rhG-CSF and HAPO treated mice both showed increased survival rate and increased colony forming units. The peripheral WBC number increased greatly. The HAPO group was most quickest compared with rhG-CSF group and PBS control group. The number of bone marrow cells at day 14 of rhG-CSF group was higher than that in HAPO group, but the number of bone marrow cells at day 32 of rhG-CSF was lower than that in HAPO group. The number of bone marrow cells at day 42 of rhG-CSF was below normal. The number of bone marrow cells at day 42 of HAPO group was nearly normal. The number of CFU-GEMM in HAPO group was most compared with that in rhG-CSF group and PBS control group at day 7, 14 and 21 after radiation. The survival rate of cells after radiation in HAPO group was markedly higher than that in PBS control group, but the survival rate of cells after radiation in rhG-CSF group was no notable difference compared with that in PBS control group. In MTT assay, both HAPO and rhG-CSF incubation stimulated proliferation of bone marrow cell at 72 hours after radiation. Bone marrow cells formed Hematopoietic islands in HAPO group after radiation and were positive for sca-1 and CD31. CD31 positive endothelial cells increased around the Hematopoietic islands. There was no Hematopoietic islands formation, few CD31 positive endothelial cells and no sca-1 positive cells in PBS control group. Conclusion: HAPO can promote hematopoiesis reconstitution in sub-lethally irradiated Balb/c mice. It can increase the survival rate of mice and stimulate the proliferation of hematopoietic stem cells.

BACKGROUNDCryopreserved embryo transfer has become indispensable in reproductive technology. More and more children are conceived from frozen-thawed embryo transfer (FET). The risk of birth defects associated with frozen-thawed embryo transfer has been evaluated and conflict results are obtained. The aim of this study was to compare the rate of major malformations in children conceived from cryopreserved embryos with that of children from fresh embryos.

METHODSA retrospective analysis was performed on children conceived from frozen-thawed embryos and fresh embryos between January 2005 and December 2008 at the Reproduction Center of the Third Hospital, Peking University. The major malformation rates were compared between two groups for all children, as well as singletons or twins, separately. The frequencies of different subtypes of malformations classified according to different organ system were also compared.

RESULTSThirty-four of 3125 children from cryopreserved embryos had a major malformation. The malformation rate was 1.09%, which was comparable to that for children after fresh embryos transfer (1.53% (55/3604), OR: 0.71, 95%CI; 0.46-1.09). The malformation rate was also similar when the analysis was limited to children from cryopreserved embryos resulted from in vitro fertilization (IVF) (1.39%) and fresh IVF (1.3%). However, children from cryopreserved embryos resulted from intracytoplasmic sperm injections (ICSI) had much lower malformation rate than from fresh ICSI (0.63% vs.1.83%, OR: 0.34, 95%CI: 0.16-0.75). No difference was found in the incidence of major malformations in singletons from cryo ICSI (0.73%) and fresh ICSI (1.9%), or from cryo IVF (1.49%) and fresh IVF (1.67%). Similar malformation rate was found in multiples from cryo ICSI (0.52%) and fresh ICSI (1.76%), or cryo IVF (1.30%) and fresh IVF (0.90%). The distribution and risk of the subtype of malformations, such as cardiovascular, gastrointestinal, neural tube, urogenital, musculoskeletal and facial abnormalities was not different between the cryo group and fresh group.

CONCLUSIONSThe major malformation rate is similar between fetuses/children conceived from cryopreserved embryos and those from fresh embryos. Large prospective and long-term follow-up studies are needed to get exact results concerning the birth defects of the children born after cryopreserved embryos.

Cryopreservation ; Embryo Transfer ; methods ; Female ; Fertilization in Vitro ; methods ; Humans ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

OBJECTIVETo investigate whether thrombus aspiration plus intra-infarct-related artery bolus administration of tirofiban via the aspiration catheter is superior to thrombus aspiration alone in improving myocardial perfusion in patients with ST-elevation myocardial infarction (STEMI) undergoing primary angioplasty.

METHODSIn this single center retrospective study, 108 patients with STEMI who underwent angioplasty after thrombus aspiration plus intra-infarction related artery 500 µg tirofiban administration, with subsequent 12-hour intravenous infusion of 0.1 µg×kg(-1)×min(-1) after angioplasty (thrombus aspiration + tirofiban group) and 108 matched control patients with STEMI who underwent angioplasty after thrombus aspiration (thrombus aspiration group). The primary end points included thrombolysis in myocardial infarction (TIMI) flow immediately after angioplasty, complete ST-segment elevation resolution (> 70%) at 90 minutes after angioplasty and the peak of creatine kinase-MB (CK-MB) and troponin I (TnI). The secondary end points were the left ventricular ejection fraction (LVEF) in the hospital and at 9 months follow-up as well as major adverse cardiac events (MACE: cardiac death, target vessel revascularization, re-infarction) at 9 months and any bleeding events.

RESULTSBaseline characteristics of the two groups were well-balanced. The TIMI 3 flow rate (97.22% vs. 87.04%, P = 0.011) and the complete ST-segment resolution rate (66.67% vs. 50.91%, χ(2) = 6.129, P = 0.047)were significantly higher in the thrombus aspiration + tirofiban group than in the thrombus aspiration group. The peak of CK-MB (83.9 U/L vs. 126.1 U/L, P = 0.034) and TnI (42.7 ng/ml vs. 72.5 ng/ml, P = 0.029) were significantly lower in the thrombus aspiration + tirofiban group than in the thrombus aspiration group. LVEF in the hospital favored thrombus aspiration + tirofiban the group (45.7% ± 10.8%, 42.9% ± 9.9%, t = 1.99, P = 0.049). There was a tendency to decreased MACE rate at 9-month follow-up, which favored thrombus aspiration + tirofiban the group (logrank χ(2) = 2.865, P = 0.09). Bleeding events were similar between the two groups.

CONCLUSIONThrombus aspiration plus intra-infarct-related artery bolus administration of tirofiban in patients with STEMI undergoing primary angioplasty may improve myocardium perfusion, attenuate myocardial ischemia and result in a better clinical prognosis compared to thrombus aspiration alone.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Coronary Thrombosis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Retrospective Studies ; Tyrosine ; adverse effects ; analogs & derivatives ; therapeutic use

OBJECTIVETo determine whether early catheterization laboratory activation would reduce median door-to-balloon time in patients with ST elevation myocardial infarction (STEMI).

METHODSConsecutive patients with STEMI underwent primary percutaneous coronary intervention (PCI) from January 2006 to December 2008 in Beijing Anzhen Hospital were analyzed. Patients were divided into three groups. Group A included patients without prehospital ECG (n = 168), group B included patients with prehospital ECG (n = 224) and group C included patients with prehospital ECG and early telephonic notification to activate catheterization laboratory (n = 114). Primary end point was door-to-balloon time, secondary end points included peak Troponin I elevation, left ventricular ejection fraction, length of hospital stay, hospital mortality and 30 days follow-up mortality.

RESULTSBaseline characteristics were similar among groups. Door-to-balloon time and door-to-catheter laboratory time (110 minutes, 94 minutes and 85 minutes, respectively, all P < 0.01; 91 minutes, 74 minutes and 64 minutes, respectively, all P < 0.01) were significantly shorter in group B and C than those in group A. The percentage of patients with door-to-balloon time less than 90 minutes increased significantly from 32% in group A to 43% in group B and 59% in group C (P < 0.01).

CONCLUSIONEarly activation of catheterization laboratory by prehospital ECG and telephonic notification could markedly reduce door-to-balloon time in patients with STEMI.

Aged ; Angioplasty, Balloon, Coronary ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; physiopathology ; therapy ; Time Factors